Analysis of clinical efficacy of hypofractionated precision radiotherapy for lung metastases
Zhao Ruizhi1, Luo Jingwei1, Xiao Jianping1, Liu Qingfeng1, Zhang Ye1, Bi Nan1, Zhang Hongmei2, Chen Xuesong1, Wang Kai1, Ma Yuchao1, Yang Siran1, Yi Junlin1, Li Yexiong1
1 Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2 Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract：Objective To evaluate the efficacy and safety of hypofractionated radiotherapy for lung metastases (LMs). Methods From March 2007 to April 2019, 193 patients with 317 LMs including 124 male and 69 female admitted to our hospital were enrolled. The median age was 58 years old and the median KPS was 80. The primary tumors were mainly distributed in the lung (33.7%), colorectum (21.2%), head and neck (13.5%) and breast (10.9%), respectively. The clinical efficacy and side effects of hypofractionated radiotherapy for LMs were evaluated. Results The median follow-up time was 59.9 months (95%CI:55.1-64.6 months). Among 193 patients with 317 LMs, 90.7% of them were treated with 4D-CT, 69.4% for intensity-modulated radiation therapy (IMRT), 28.0% for volumetric-modulated arc therapy (VMAT) and 2.6% for tomotherapy (TOMO), respectively. The median gross tumor volume (GTV) and planning target volume (PTV) were 5.0cm3(0.2-142.3cm3) and12.0cm3(1.0-200.1cm3). The prescription dose regimen was 60Gy in 4 to 15 fractions. The median dose for PTV was 60Gy (45-70Gy) and biological effective dose was 96Gy (60-150Gy), respectively. The 1-, 3-and 5-year local control rates (LCR) were 95.7%, 91.3% and 89.9%, respectively. The median time from primary cancer diagnosis to lung metastases was a prognostic factor for LCR (P=0.027). The overall survival (OS) and progression-free survival (PFS) rates were 90.1%, 60.8%, 46.2%, and 54.3%, 30.3%, 19.9%, respectively. The median time from primary cancer diagnosis to lung metastases and extrapulmonary metastases was the prognostic factor for OS and PFS. No Grade 3 toxicities were seen. Conclusion Image-guided hypofractionated precision radiotherapy is an efficacious and safe treatment for LMs.
Zhao Ruizhi,Luo Jingwei,Xiao Jianping et al. Analysis of clinical efficacy of hypofractionated precision radiotherapy for lung metastases[J]. Chinese Journal of Radiation Oncology, 2020, 29(8): 639-643.
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2020, Vol. 29 
